Indiana
Professional Licensing Agency
Ralph J. Jacqmain
Controlled Substance Registration - Physician
License number
01020460B
Date granted
07/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
621 South 7th Street, Vincennes IN 47591
indianalicensing.org
ID 5931360
LAST UPDATED 2024-04-13 02:11:05 UTC
LAST UPDATED 2024-04-13 02:11:05 UTC
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